BILL REQ. #:  S-1703.1 

Read first time 02/25/2003.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to increasing the supply of dentists and dental hygienists to meet the critical shortage of dental providers in this state and underserved areas; amending RCW 18.32.215, 18.29.190, and 18.29.200; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds and declares that access to dental care is severely hampered by a critical and emergent shortage of dental providers in Washington state. Dental disease is an epidemic among poor children, the elderly, the disabled, and anyone who does not have access to adequate dental care. Dental decay is worsening among children under four years of age, with forty-one percent of the state's Headstart children needing treatment for dental decay. The lack of qualified dentists and dental hygienists poses a serious and compelling threat to the oral health of the people of this state.
     Shortages are also due to licensing restrictions that have discouraged qualified dentists and dental hygienists from coming into this state. Increasing the number of dentists from other states and from military service would enable retiring dentists in this state to sell their practices to other qualified practitioners.

Sec. 2   RCW 18.32.215 and 1994 sp.s. c 9 s 219 are each amended to read as follows:
     An applicant holding a valid license and currently engaged in practice in another state may be granted a license without examination required by this chapter, on the payment of any required fees, if the ((commission determines that the other state's licensing standards are substantively equivalent to the standards in this state)) applicant is a graduate of an approved dental school. The commission may also require the applicant to: (1) File with the commission documentation certifying the applicant is licensed to practice in another state; and (2) provide information as the commission deems necessary pertaining to the conditions and criteria of the Uniform Disciplinary Act, chapter 18.130 RCW, and to demonstrate to the commission a knowledge of Washington law pertaining to the practice of dentistry.

Sec. 3   RCW 18.29.190 and 1993 c 323 s 2 are each amended to read as follows:
     (1) The department shall issue a ((temporary)) limited license without the examination required by this chapter to any applicant who, as determined by the secretary:
     (a) Holds a valid license in another state that allows the scope of practice in subsection (3) (a) through (((j))) (i) of this section;
     (b) Is currently engaged in active practice in another state. For the purposes of this section, "active practice" means five hundred sixty hours of practice in the preceding twenty-four months;
     (c) Files with the secretary documentation certifying that the applicant:
     (i) Has graduated from an accredited dental hygiene school approved by the secretary;
     (ii) Has successfully completed the dental hygiene national board examination; and
     (iii) Is licensed to practice in another state;
     (d) Provides information as the secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW;
     (e) Demonstrates to the secretary a knowledge of Washington state law pertaining to the practice of dental hygiene, including the administration of legend drugs;
     (f) Pays any required fees; and
     (g) Meets requirements for AIDS education.
     (2) ((The term of the temporary)) A limited license issued under this section is ((eighteen months and it is nonrenewable)) renewable annually.
     (3) A person practicing with a ((temporary)) limited license granted under this section has the authority to perform hygiene procedures that are limited to:
     (a) Oral inspection and measuring of periodontal pockets;
     (b) Patient education in oral hygiene;
     (c) Taking intra-oral and extra-oral radiographs;
     (d) Applying topical preventive or prophylactic agents;
     (e) ((Polishing and smoothing restorations;
     (f))) Oral prophylaxis and removal of deposits and stains from the surface of the teeth;
     (((g))) (f) Recording health histories;
     (((h))) (g) Taking and recording blood pressure and vital signs;
     (((i))) (h) Performing subgingival and supragingival scaling; and
     (((j))) (i) Performing root planing.
     (4)(a) A person practicing with a ((temporary)) limited license granted under this section may not perform the following dental hygiene procedures unless authorized in (b) or (c) of this subsection:
     (i) Give injections of local anesthetic;
     (ii) Place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration;
     (iii) Soft tissue curettage; or
     (iv) Administer nitrous oxide/oxygen analgesia.
     (b) A person licensed in another state who can demonstrate substantively equivalent licensing standards in the administration of local anesthetic may receive ((a temporary)) an endorsement to administer local anesthesia.
     (c) A person licensed in another state who can demonstrate substantively equivalent licensing standards in restorative procedures may receive ((a temporary)) an endorsement for restorative procedures.

Sec. 4   RCW 18.29.200 and 1993 c 323 s 3 are each amended to read as follows:
     A person granted a ((temporary)) limited license under this chapter who does not meet the requirements for substantively equivalent licensing standards in restorative or local anesthetic must submit proof of completion of approved education in these procedures before being eligible to take the dental hygiene examination.